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General NPI Number Information
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NPI Number | 1295079978
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Entity Type | Organization
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Legal Business Name | ACCELLENCE LAS VEGAS
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 4815 W RUSSELL RD STE 4D
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City | LAS VEGAS
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State | NV
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Zip | 89118-6241
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Country | US
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Telephone | 702-740-4138
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Fax | 702-740-4153
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Provider Business Mailing Address
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Address Line | 35 N EDISON WAY STE 37
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City | RENO
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State | NV
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Zip | 89502-2352
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Country | US
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Telephone | 775-787-8880
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Fax | 775-352-9333
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Authorized Official
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Title or Position | MANAGER
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Name | JOHN R HOWITT
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Credential | R.R.T, ATP
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Telephone | 775-787-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 1000087786
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1000087786
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License Number State | NV
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